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The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should consider which information when planning care for this patient?
- A. Capitation provides the hospital with a means of recovering variable charges.
- B. The hospital will be paid for the full cost of the patient’s hospitalization.
- C. Diagnosis-related groups (DRGs) provide a fixed reimbursement of cost.
- D. Medicare will pay the national average for the patient’s condition.
Correct Answer: C
Rationale: In 1983, Congress established the prospective payment system (PPS), which grouped inpatient hospital services for Medicare patients into diagnosis-related groups (DRGs), each of which provides a fixed reimbursement amount based on assigned DRG, regardless of a patient’s length of stay or use of services.
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When a pregnant woman develops ptyalism, which guidance should the nurse provide?
- A. Chew gum or suck on lozenges between meals.
- B. Eat nutritious meals that provide adequate amounts of essential vitamins and minerals.
- C. Take short walks to stimulate circulation in the legs and elevate the legs periodically.
- D. Use pillows to support the abdomen and back during sleep.
Correct Answer: A
Rationale: The correct answer is A: Chew gum or suck on lozenges between meals. Ptyalism is excessive saliva production during pregnancy. Chewing gum or sucking on lozenges can help manage excessive saliva by promoting swallowing and reducing the sensation of saliva accumulation. This guidance addresses the symptom directly. Choices B, C, and D do not specifically address ptyalism. B focuses on nutrition, C on circulation, and D on physical comfort, which are important aspects of pregnancy but not directly related to managing ptyalism.
The health care practitioner caring for a pregnant client diagnosed with gonorrhea writes the following order: ceftriaxone 250 mg IM × one dose. The medication is available in 1-gram vials. The nurse adds 8 mL of normal saline to the vial. How many mL of the medication should the nurse administer? Calculate to the nearest whole.
- A. 2 mL
- B. 3 mL
- C. 4 mL
- D. 5 mL
Correct Answer: A
Rationale: The nurse should administer 2 mL of the medication. The calculation is based on the concentration of the medication after dilution.
A nurse is evaluating care based upon the nursing quality indicators. Which areas should the nurse evaluate? (Select all that apply.)
- A. Patient satisfaction level
- B. Hospital readmission rates
- C. Nursing hours per patient day
- D. Patient falls/falls with injuries
Correct Answer: C
Rationale: The American Nurses Association developed the National Database of Nursing Quality Indicators (NDNQI) to measure and evaluate nursing-sensitive outcomes with the purpose of improving patient safety and quality care. Nursing quality indicators include the following: Hospital readmission rates, nursing hours per patient day, and patient falls/falls with injuries. While every major health care organization measures certain aspects of patient satisfaction, it is not a nursing quality indicator.
In which type of health care facility does the nurse want to work if applying for a position with a home care organization that specializes in spinal cord injury?
- A. Secondary acute
- B. Continuing
- C. Restorative
- D. Tertiary
Correct Answer: C
Rationale: Patients recovering from an acute or chronic illness or disability often require additional services (restorative care) to return to their previous level of function or reach a new level of function limited by their illness or disability.
The nurse is preparing to teach a client how to perform daily fetal kick counts. Which instruction is most important for the nurse to give the client?
- A. Count fetal kicks prior to eating a meal
- B. Lie on back when counting kicks
- C. Call provider if at least three movements are not felt in 1 hour
- D. Count all movements over 1 hour
Correct Answer: C
Rationale: The correct answer is C: Call provider if at least three movements are not felt in 1 hour. This instruction is crucial because decreased fetal movements can indicate potential fetal distress. By advising the client to contact the healthcare provider if fewer than three movements are felt in an hour, the nurse is emphasizing the importance of promptly seeking medical attention when there may be a concern for the baby's well-being.
A: Counting kicks prior to eating a meal is not as important as monitoring the baby's movements consistently throughout the day.
B: Lying on the back when counting kicks is not recommended, as it can reduce blood flow to the uterus and potentially affect the baby.
D: Counting all movements over 1 hour may not capture a decrease in movements that could be a cause for concern, as the focus should be on monitoring a specific minimum number of movements within a set timeframe.
In summary, the correct answer emphasizes the need for prompt action in case of decreased fetal movements, while